Multimodal osteopathic manipulative treatment is efficacious for chronic low back pain (LBP).1 However, systematic reviews have excluded osteopathic studies that have used multimodal treatments because they do not assess each technique individually.2-4 Researchers in Spain performed a double-blind randomized sham-controlled trial to evaluate the effects of using only myofascial release (MFR) therapy on pain level (using the Short Form McGill Pain Questionnaire [SF-MPQ] and Visual Analog Scale [VAS]), disability (using the Roland-Morris Questionnaire), and fear-avoidance beliefs (using the Fear-Avoidance Belief Questionnaire) in patients with chronic LBP.